MEDICARE: UPGRADES IN HEALTH AND WELLNESS COASTAL HYPERBARIC HARRIET SEGELCKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1457958068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPGRADES IN HEALTH AND WELLNESS COASTAL HYPERBARIC HARRIET SEGELCKE

Provider Business Mailing Address
First Line	:	225 CABRILLO HWY S STE 110D
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	408-384-1186
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 CABRILLO HWY S STE 110D
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	408-384-1186
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HARRIET SEGELCKE
Credential	:
Telephone Number	:	650-703-0583

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	04/19/2023

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